Validation of a standardized training system for robot-assisted radical prostatectomy: comparison of perioperative and surgical outcomes between experienced and novice surgeons at a low-volume institute in Japan

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Minim Invasive Ther Allied Technol. March 30, 2022: 1-9. doi: 10.1080/13645706.2022.2056707. Online ahead of print.


INTRODUCTION: Although robot-assisted radical prostatectomy (RARP) has become a standard treatment modality for patients with prostate cancer (PCa), RARP is a complicated and difficult surgical procedure due to the risk of complications serious from surgery. This study aimed to assess the validation of a standardized training system for RARP in patients with PCa at a single institute.

MATERIALS AND METHODS We retrospectively reviewed the clinical and pathological records of 155 PCa patients who underwent RARP at Gifu University between August 2018 and April 2021. We developed an institutional program for new surgeons based on the separation of the six-point RARP procedure. The primary endpoints were surgical outcomes and perioperative complications among three groups (expert, trainer, and novice surgeon groups).

RESULTS: Console time was significantly longer in the novice surgeon group than in the other groups. Regarding dissection of the bladder neck, ligation of the lateral pedicles and vesico-urethral anastomosis, the operating time was significantly shorter in the expert group than in the other groups. Complications related to surgery occurred in 15 patients (9.7%).

CONCLUSIONS: Our training system for RARP could help reduce the influence of the learning curve on surgical outcomes and ensure that surgeries performed in low-volume facilities are safe and efficient.

PMID:35352619 | DO I:10.1080/13645706.2022.2056707

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